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Biomedical subjects

A Béchetoille

Publications and source records attributed to A Béchetoille.

At least 19 recordsLinked to original sources
PubMed1995

[Acute angle-closure glaucoma].

Acute angle-closure glaucoma is an ocular disorder essentially linked to specific anatomical formations, particularly hereditary, in which, as of a critical age and influenced by random triggering factors, unilateral or bilateral blockage of the pupil occurs. This leads to closing of the iridocorneal angle followed by severe ocular hypertonia and, if emergency treatment is not begun, to severe complications of the eye and the vision. Treatment is first by osmotic agents (acetazolamide), beta-blocking collyria and myotic agents, followed obligatorily by surgical or laser iridectomy of the affected eye, then of the other eye as a preventive measure.

Acute Disease↗
PubMed1995

[Arterial hypotension in glaucoma of normal or moderately high pressure].

BACKGROUND: Arterial hypotension, by decreasing blood flow in the optic nerve head, may be a risk factor for glaucomatous damage. The purpose of this study was to compare blood pressure in different types of glaucoma patients, using ambulatory recording. METHODS: An ambulatory blood pressure recording was performed in 55 glaucoma patients over a 24-hour period. Two groups of patients could have been differentiated according to pretreatment intra-ocular pressure level: a group of 38 patients (GPNM) with normal or moderately elevated intra-ocular pressure, and a group of 17 patients (GPH) with high intra-ocular pressure. RESULTS: A statistically significant different lower blood pressure was found in group GPNM for: diastolic mean blood pressure (76.4 versus 81.4 mmmHg p = 0.05), diastolic nocturnal (71.8 versus 78.1 mmHg p = 0.025), and for some hourly intervals: from 2:00 to 3:00 (p = 0.008), 8:00 to 9:00 (p = 0.01) and 15:00 to 18:00 (p = 0.03). The mean lowest readings were lower (p < 0.05) in group GPNM (95.8/54.4 versus 102/59.9 mmHg). The percentage of low readings (9.9% versus 5.1% p = 0.01) and systolic drops (0.226 versus 0.192 p = 0.018) were also higher in this group. CONCLUSION: Hypoperfusion of optic nerve head may be a significant factor in glaucomatous damage by compromising blood supply. It is important to identify arterial hypotension when examining of normal or moderately elevated pressure glaucoma patients, and ambulatory monitoring of blood pressure is currently the best test. These episodes should be taken into consideration, especially when initiating systemic antihypertensive therapy, in order to maintain, as well as possible, perfusion of the optic nerve head.

Blood Pressure Monitoring, Ambulatory↗
PubMed1992

Sezolamide: additivity to timolol twice daily.

Sezolamide, a potent topical carbonic anhydrase inhibitor previously known as MK-417, was studied to determine its ocular hypotensive activity in patients with elevated intraocular pressure while on continuing therapy with topical timolol. This was a three-centre, double-masked, randomised, placebo-controlled, parallel study in 36 patients with bilateral primary open angle glaucoma or ocular hypertension on therapy receiving 0.5% timolol twice daily, with a morning intraocular pressure greater than or equal to 22 mmHg in both eyes 2-4 hours following an 8 a.m. dose of timolol. Sezolamide 1.8% or placebo twice daily was added to treatment with timolol on the evening of day 1 and continued for 2 weeks. Twelve-hour diurnal curves were performed before the study on day 1 (timolol alone) and on day 15. Intraocular pressure measurements were also taken on days 2 and 8 at 8 a.m. and 9 a.m. Patients who received timolol and sezolamide showed additional intraocular pressure reductions from day 1 (timolol alone) of 8.0 to 15.5%, which were significant at all times. At hours 1, 2, 4 and 8 the reductions in intraocular pressure observed in the group receiving sezolamide and timolol were significantly greater than those in the group receiving timolol and placebo.

Aged↗
PubMed1991

[Additive effect of timolol and the local carbonic anhydrase inhibitor MK-417 (sezolamide)].

MK-417 (sezolamide) is a topically active carbonic anhydrase inhibitor. The effect of additional treatment with sezolamide 1.8% twice daily to patient already receiving timolol 0.5% twice daily was investigated. For this purpose, 12-h diurnal curves were used in a double-masked, randomized, placebo-controlled, parallel study in 36 patients with bilateral primary open angle glaucoma or ocular hypertension who during beta blocker therapy had intraocular pressures (IOP) greater than or equal to 22 mmHg. For 15 days patients received sezolamide or placebo 10 min after 0.5% timolol given at 8 a.m. and 8 p.m. On treatment day 15, this addition of sezolamide twice daily induced a further mean decrease in IOP of approximately 4 mm Hg (about 15%) at 1, 2 and 4 h and of approximately 2-3 mm Hg at 0, 6, 8, 10 and 12 h after drug administration, thus demonstrating a partial additive effect of sezolamide and timolol. Thus, sezolamide may be a useful addition to the treatment of glaucoma in patients not adequately controlled by beta blocker therapy.

Aged↗
PubMed1986

[Data bank for analysis of the normal visual field using the 30/1 central program of the automated Humphrey perimeter].

Quantification is one of the most interesting improvements given by the automated perimetry. Such approach has, for instance, permitted the development by J. Flammer of quantification indices for JO program of Octopus. However, for working this concept needs quantitative data on normal visual field. Using an Humphrey automated perimeter and central threshold 30/1 program, we have gathered with the "quantification" program ley Thot Informatique, normal data on 178 visual field from 117 normal outpatients attending Ophthalmology Department of the Angers Hospital (58 females-59 males). Then, those data have been ranked by age, to obtain reference visual fields and corresponding standard-deviation fields. There is a decrease in visual sensitivity in the superior part of the 30 degrees field when compared to inferior. There is a decrease in visual sensitivity with ageing-about 1 dB by decade-more in the peripheral part of the 30 degrees field than in the central part. Standard deviation visual field is of considerable interest to valid pathologic visual field detects. There is an increase standard deviation for the peripheral part of the 30 degrees field. Finally, standard deviation is increased in elderly people as compared to younger.

Adult↗
PubMed1985

[Congenital ectropion of the iris epithelium and glaucoma].

Two cases of unilateral ectropion uveae with ipsilateral juvenile glaucoma are reported including one with ipsilateral ptosis. This rare, non progressive anomaly, is characterized by the presence of iris pigment epithelium on the anterior surface of iris stroma, quite often associated with neurofibromatosis, ipsilateral ptosis or Rieger's syndrome. Congenital or juvenile glaucoma is almost systematically associated with the condition and must be evaluated and treated. Pathogeny of the anomaly has to be interpreted keeping in mind the concept of neurocristopathy, i.e. developmental anomalies of neural crest origin tissues.

Anterior Chamber↗
PubMed1985

[Gonioretraction using argon laser].

Argon laser trabeculoplasty (ALT) has recently become one of the most popular procedures in the treatment of chronic open angle glaucoma. Although ALT is quite efficient, its mode of action is far from understood and the rate of complications or side effects is not negligible. In 1981 we began exploring a different procedure that we have called argon laser gonioretraction (ALG) with reference to the Cairns surgical goniospasis. While the corneo-scleral trabeculum is the target for argon laser beams in ALT, in ALG the beams are directed toward the ciliary band in an attempt to get the scar to pull the scleral spur backwards and stretch the trabeculum. The procedure may also act through the uveal trabeculum. The procedure was first utilized from 1981 to 1983 in 43 chronic open angle glaucoma eyes with: 1/ a high rate of success in decreasing the intraocular pressure on a long term basis, 2/ an acceptable rate of complications. 18 months after laser surgery, intraocular pressure was fully controlled without any medical treatment in 19 cases (44%). 18 additional cases (42%) were controlled with the help of less medical treatment than before. In 4 cases (8%) the failure was complete including one case with significant prolonged and non-responsive post-op hypertension which has induced a slight alteration of the visual field. One case was lost to follow-up. Supposed advantages of ALG over ALT are: integrity of the corneo-scleral trabeculum is maintained, goniosynechiae are more peripheral, and there is less propensity to induce proliferation of endothelial cells.

Adult↗
PubMed1984

[Intracorneal suture. A simple procedure for the correction of astigmatism after cataract operation].

A simple surgical procedure to cure post cataract-surgery astigmatism is reported. Corneo-corneal (sometimes corneo-scleral), 9-0 polyamide monofilament sutures are put in radially at the end (or at the two ends) of the flattest meridian to increase its curvature and therefore its refractive power. 14 eyes were treated by this procedure, 11 of them for an "against the rule" astigmatism (1st group) and the 3 others for a "with the rule" astigmatism (2nd group). No corneal incision or resection is performed before suturing. Surgery has been efficient in all cases. As compared to a mean pre-op against the rule astigmatism of 6.55 +/- 2.20 diopters, the post-op residual astigmatism was no more than 3.16 +/- 1.94, 2.66 +/- 1.17, 2.69 +/- 1.33 and 2.80 +/- 1.74 diopters, respectively 8 days, 3 months, 6 months, 12 months after the surgery. The average axis of the effect of the surgery was almost perpendicular to the initial axis of the astigmatism. The visual acuity also improved but was dependent on other factors in addition to the refractive surgery. The results were stable from 3 months after surgery and remained unchanged in those cases where the follow-up period was 18 months or more. No significative complications have been observed and side effects have been negligible. In our opinion, the results that we have obtained open the way to the intracorneal suture, without any section of the cornea, as a potential treatment for excessive astigmatism.

Aged↗
PubMed1983

[Modifications in blood zinc and lead concentrations and ALA-dehydratase activity in optic neuropathy from alcohol and tobacco abuse].

Plasma red blood cell and total blood zinc levels were significantly decreased in 52 consecutives cases of bilateral, retrobulbar, axial optic neuropathy caused by chronic abuse of ordinary wine and/or beer and/or hard beverages and cigarette smoking principally in men in their forties [plasma zinc: 746 mg/l +/- 179 (n = 52), control 907 mg/l +/- 127; red blood cell zinc: 10,218 mg/l +/- 1,327 (n = 10), control 12,244 mg/l +/- 1,307; total blood zinc: 4,849 mg/l +/- 1,069 (n = 51), control 5,831 mg/l +/- 644]. In contrast, blood lead levels were increased in these cases - blood lead: 344 mg/l +/- 101 (n = 30), control 193 mg/l +/- 94. Activity of red blood cell delta-amino-levulinic acid dehydratase (ALA-dehydratase), a zinc dependent enzyme, was decreased [red blood cell ALA-dehydratase; 18,8 IU/l +/- 2,2 (n = 13), control 44,8 IU/l +/- 3,3]. Plasma magnesium was slightly decreased while serum copper was not significantly modified. Possible ophthalmological implication of these findings are discussed.

Alcoholism↗
PubMed1983

[Therapeutic affect of zinc sulfate on central scotoma due to optic neuropathy of alcohol and tobacco abuse].

The oral administration of 400 mg/day for one month of zinc sulphate, when compared with placebo, provoked normal plasma zinc level in treated patients, principally men in their forties, with bilateral, retrobulbar, axial, optic neuropathy related to excessive smoking and consumption of ordinary wine and/or beer and/or spirits. Treatment significantly improved visual capacity (measured with Friedmann analyser) of the central scotoma area (5 degrees).

Alcoholism↗